Gregory Stafford MP: speeches

Speeches

• 2 Jul 2026 · Health Bill (Tenth sitting) · Hansard source

  More

  As ever, my hon. Friend is entirely right. It would be helpful to have more clarity on what the single patient record will look like. I will not repeat my earlier questions, but I think they are prescient. I hope that the Minister—even if she cannot answer now, which I accept—has those in mind when she and her colleagues start to look at this. Even if the Minister cannot provide detail, all I ask is that she provides reassurance that access to the single patient record will be based on explicit consent, limited to what is necessary for either the caring role—as in the amendment of the hon. Member for Winchester—or the clinical role overall, subject to some kind of regular review and supported by some robust audit mechanism. If we are to create a system on this scale, we must ensure that the safeguards are just as strong as the benefits.

• 2 Jul 2026 · Health Bill (Tenth sitting) · Hansard source

  More

  My hon. Friend is right again: there is a lack of clarity in these two clauses, as I have highlighted. I am sure the Minister, having heard my hon. Friend’s question, will respond when she gets her moment.

• 2 Jul 2026 · Health Bill (Tenth sitting) · Hansard source

  More

  I will be charitable and take him at his word. We have opened a vital conversation about who will have access to this record, how it will be shared, which bits of it will be shared, and how we ensure that the laudable aim of a single patient record—to ensure that a clinician treating a patient has all the vital facts in front of them—is balanced with that patient’s privacy. As the shadow Minister, my hon. Friend the Member for Sleaford and North Hykeham said, we must make sure that the patient is put at the centre of this. We need to look at the amendment under that microscope of scrutiny. We must use our role as legislators to ensure that gaps in legislation are closed so that loopholes cannot be exploited. I am fully in favour of the Government’s intention on that. However, I have some concerns about privacy and access, and amendment 8 potentially highlights those. The amendment provides for a nominated carer to access a patient’s record, but who nominates the carer? Is it always the patient, and how will that consent be verified and continually checked so that if the patient wishes to remove consent for the carer to see their record for whatever reason, there is a way of doing so? What protections exist for vulnerable patients who may feel pressured or even coerced into granting access? If circumstances change, how easily can that access be withdrawn, by whom and through what process? Although I am not being critical specifically of the amendment, the Government will need to think about those questions when they introduce the single patient record. It is not as simple as saying, “Here is a wonderful record and everyone can access it,” because it will contain some of the most sensitive information an individual holds, including details of their physical and mental health. I entirely accept that carers often play a vital role in supporting patients, but unrestricted or poorly governed access could undermine patient confidentiality and therefore trust in the system. I am sympathetic to the concerns of the hon. Member for Winchester and think that, not just in relation to this amendment but as the record is pulled together, we really need to consider these vital issues. On amendment 65, like the shadow Minister, I have a lot of sympathy with the point about reasonable adjustments. We need to be careful when deciding as legislators the purpose of the single patient record. Is it simply a repository of treatments, illnesses, conditions and so on, or does it give a wider commentary on those conditions and treatments? In the example given by the shadow Minister, knowing that someone has hearing difficulties would be useful, but is the single patient record the appropriate place for that? I do not know the answer, but we need to discuss and decide that, because there is a danger of scope creep. If we try to make it all things to all men and women, it could lose the stated purpose, which is to ensure that a clinician has the full facts when dealing with a patient.

• 30 Jun 2026 · Health Bill (Eighth sitting) · Hansard source

  More

  Very briefly, on clauses 27 and 28, I am sure the Committee is aware that special health authorities were initially established under the National Health Service Act 1977. Since then the number of special health authorities has expanded and contracted a number of times over the years to leave us with, currently, NHS Blood and Transplant, and the Business Services Authority, which covers pensions, as my hon. Friend the Member for Sleaford and North Hykeham mentioned—I should declare that I have an NHS pension, albeit a very small one—as well as the NHS Litigation Authority, also known as NHS Resolution, and the NHS Counter Fraud Authority. The mood music and the direction of travel, certainly since 2006, has been to reduce the number of special health authorities. On my reading, clauses 27 and 28 suggest that the Government are potentially looking to expand the number of special health authorities, given the Secretary of State’s direction under clause 27 and the practical steps for staff transfers in clause 28. Is the Minister looking at, for example, a special health authority to deal with artificial intelligence? Clearly that is something the NHS will have to embrace—or deal with, depending on which end of the AI argument one is on—rapidly over the coming years. Is that a potential area for a special health authority? Perhaps the Minister could outline where she sees the special health authorities acting and what their remits might be.

• 30 Jun 2026 · Health Bill (Eighth sitting) · Hansard source

  More

  We can go back to the record in Hansard , but I do not remember mentioning anything to do with hospitals in what I just said; I may have had some sort of amnesia at that point. If the hon. Member is referring to the plan of the last Government, which was fully costed, for 40 new hospitals, then I am afraid I did not mention that. On his wider point, Conservative Members want to understand how local authorities and deliverers of primary care—dental services and so on—will be included and can have influence over the plans and strategies that ICBs draw up. I fully support that ambition; I just feel that, if we are to have that ambition, we need to table amendments and new clauses that the Minister might actually accept, so that we can go forward.

• 30 Jun 2026 · Health Bill (Eighth sitting) · Hansard source

  More

  The hon. Gentleman’s intervention neatly brings me to my next point. I have some sympathy for his viewpoint—and apparently the viewpoint expressed to him by governors—that in many cases, if not most, governors do not have the teeth, the influence or the ability to change things in the way they would like. My argument is very similar to the one we will expand on later regarding the abolition of the Healthcare Services Safety Investigations Branch and Healthwatch: the Government’s response to something not working as effectively as it could is to abolish it, but why not give those organisations the teeth—the powers—to achieve the things they were set up to do, unless the hon. Gentleman and the Government feel that there is no need, in Healthwatch’s case, for that level of independent scrutiny or, in governors’ case, that level of independent influence on boards? There is a fundamental difference here: the Conservatives would take something imperfect and make it better; the Government’s response is to take something imperfect and abolish it. That is the wrong way round.

• 30 Jun 2026 · Health Bill (Eighth sitting) · Hansard source

  More

  I thank the hon. Lady for that clarification. It is helpful to understand that the Liberal Democrats will not press the new clause to a vote, but if we are to use probing amendments effectively, they need to be drawn much more tightly, so that a Minister does not have the opportunity—I am sure that today’s Minister would not do this—to wriggle out of it because it is so poorly drafted.

• 30 Jun 2026 · Health Bill (Eighth sitting) · Hansard source

  More

  On clause 29 and the relevant amendments, the membership model and the council of governors were originally introduced to give patients, staff and local communities a formal voice in the governance of NHS organisations. I worry that by removing them the clause concentrates power in the hands of the trust board at a local level and, potentially, the Secretary of State at a national level, while reducing opportunities for local scrutiny and public participation. As my hon. Friend the Member for Sleaford and North Hykeham said, there is a real danger that organisations will be independent in name only. That brings us back to the never-ending tension in the Bill between the centralisation of power in the Secretary of State, through the abolition of NHS England and all the other bodies we have talked about, and the Government’s stated desire to have more accountability for decision making at a local level.

• 30 Jun 2026 · Health Bill (Eighth sitting) · Hansard source

  More

  It is a pleasure to serve under your chairmanship, Sir Jeremy. I want to pick up where the shadow Minister left off. Essentially, she said that the cart is being put before the horse in terms of mayoral authorities. As my hon. Friend the Member for Isle of Wight East outlined, many areas have no plans for a mayoral authority; our area of Hampshire and the Isle of Wight is some way down the track. As I expressed last week in Committee, we have a strange anomaly in the new Surrey and Sussex ICB, because Sussex will get a mayor and Surrey will not, so Sussex residents will have representation on the ICB whereas Surrey residents will not. I hope that the Minister has had a chance to reflect on that strange paradox over the weekend and that she will now be able to answer specifically, as she did not last week, how that lack of representation for Surrey residents will work locally. The abolition of the integrated care partnerships and their allied strategies continues a theme whereby the Government, under the veneer of slimming down, are actually decoupling—or weakening or whatever terminology Members wish to use—health and social care. For many years, all parties have regarded the bringing together of health and social care as essential, but the Bill not only looks like it is not trying to encourage that bringing together, but in fact is doing the opposite of that—it seems to be looking to pull them apart and decouple them. That is strange, because it does not appear to be the expressed policy of the Government, but it is the only logical explanation for many parts of the Bill, including the abolition in clause 23. The shadow Minister pointed out that a number of areas will keep the ICPs in some form or other. I ask the Minister, does the Government support that feature? Was it the Government’s intention to remove the statutory footing of the ICPs and strategies in the hope and expectation that they would continue on a non-statutory footing? If so, we come to the paradox: if the Government support local authorities and health services continuing to work together in informal ICPs, why is the Minister trying to get rid of them? If they do not support that, is it now stated Government policy to separate social care and health services?

• 30 Jun 2026 · Health Bill (Eighth sitting) · Hansard source

  More

  My hon. Friend is right that there will be a gap in local decision making on these issues. It goes back to that tension I described some moments ago: the Government’s stated intention is to devolve powers locally, but they seem to be pulling so much power up to the Secretary of State that we will lose the ability to make local decisions for the benefit of local populations where appropriate. We have a stated ambition for neighbourhood health, but those neighbourhoods are rapidly expanding in this legislation to become areas of millions of people. Local people who are interested in their local health delivery or local hospital trust would not see that as local decision making, and there is the gap that my hon. Friend describes. I do not think that amendments 74 and 75 have been moved, so I will not talk about them. Government amendment 19 will require “NHS foundation trusts to have at least one executive director who is a registered medical practitioner or a registered dentist and another who is a registered nurse or a registered midwife.” As also stated in the explanatory note, and as the Minister mentioned, regulations may create exception—for example, for ambulance trusts. That is the right decision, and it is important that we have medical experience on foundation trust boards. I am interested in understanding from the Minister, first, why she has chosen a medical practitioner or registered dentist. Does she see some equivalence in their expertise that could be substituted? I have great respect for doctors and for dentists, but they have potentially different clinical expertise. If a foundation trust does no oral healthcare or maxillofacial reconstruction, and does no dentistry or allied specialties, would it really satisfy requirements to have a dentist on the board? Likewise, given that the amendment also refers to a registered nurse or midwife, if a trust has no maternity services, would having a midwife on the board really satisfy the requirement of that trust to have nursing care input? I ask those questions, and I would be interested in the answers. Likewise, there is the exemption for ambulance trusts. Like my hon. Friend the Member for Sleaford and North Hykeham, I would be interested to understand from the Minister why she thinks ambulance trusts do not need a medical practitioner on their boards, given that they are doing medicine. Plenty of consultants work alongside paramedics and in ambulances, so again I am not quite sure why she is making that exemption. I would be interested to hear from her on that. I understand the intention behind Liberal Democrat amendment 36. Once again, it is trying to soften the Secretary of State’s power grab over decision making—like the hon. Member for North Shropshire, I am not saying anything against the current Secretary of State, but a future Secretary of State could be different. The aim is to try to temper that in some way. Unfortunately for the hon. Member—I have sympathy for the amendment—the stated intention of the Bill is to pull more power to the Secretary of State. The Minister may surprise me, but I fear that the amendment will not find favour with the Government, because the whole Bill is about pulling more power to the centre, certainly when it comes to appointments, and to the Secretary of State. However, the Minister should think about how future Secretaries of State may have to go through some process whereby their decisions are checked and justified, especially at local level. If we want local people to have influence and say over their local health systems and trusts, there needs to be some sort of bridging legislation or bridging process to ensure that whatever a Secretary of State decides, it has the confidence and support of local people and local service providers.

• 30 Jun 2026 · Health Bill (Eighth sitting) · Hansard source

  More

  Will the Minister give way?

• 30 Jun 2026 · Health Bill (Eighth sitting) · Hansard source

  More

  I am not convinced that clause 24 delivers the transformation that the Minister claims. At its core, it appears to be little more than a rebranding exercise. It replaces joint local health and wellbeing strategies with neighbourhood health plans, but does remarkably little to strengthen the underlying duties on local authorities or integrated care boards. Merely changing the name of a document does not improve patient outcomes, reduce waiting lists or deliver more integrated care. The duty created by the clause is also remarkably weak. Local authorities and ICBs need only prepare a plan and then “have regard” to it when exercising their functions. That is one of the least demanding obligations available in legislation. It requires consideration, not compliance. An ICB could acknowledge the plan, but decide to depart from it and still satisfy the legal test. If neighbourhood plans are genuinely intended to drive local health policy, the Bill should do a lot more to require decision makers to act in accordance with them, or at the very least to explain publicly why they have chosen not to. I am also concerned that the clause creates additional bureaucracy without any clear accountability. It requires the production of another planning document, another consultation exercise and another set of reporting expectations, but provides for no—for want of a better phrase—enforcement mechanism or measurable outcomes against which success can be judged. There is a risk that local systems will spend their time drafting plans rather than delivering services. Public involvement is of course essential, and indeed welcome, as we have heard, but the clause offers no detail about what meaningful involvement looks like and contains nothing to prevent a token consultation from satisfying the statutory requirement. If the objective is genuine neighbourhood-led healthcare, the legislation needs to be drafted much more tightly. Moving on to new clause 70, I do my absolute best not to be flippant when it comes to Lib Dem amendments and new clauses, but once again we have an idea that is fine in principle—in fact, I think we would all support it in principle—yet the hon. Member for Winchester could hardly articulate how the new clause would work and whom it would involve.

• 30 Jun 2026 · Health Bill (Ninth sitting) · Hansard source

  More

  My hon. Friend is making a prescient point. Has she thought about the word “limits”? To me, it is not clear from the clause as drafted—perhaps it is clearer to her—whether that is an overall limit on capital and revenue expenditure, or whether the clause is saying that the Secretary of State could impose limits on individual line items or departments. The word “limits”—plural—suggests that he or she may be able to do that.

• 30 Jun 2026 · Health Bill (Ninth sitting) · Hansard source

  More

  I want to touch briefly on clause 39, Government new clause 20, and new clause 26, tabled by the hon. Member for Oxford West and Abingdon in her role as Chair of the Health and Social Care Committee. I recognise the intention behind clause 39. Greater collaboration between the NHS, local authorities and other public bodies has the potential to improve the co-ordination of services and deliver a more integrated approach to population health, which I think we all welcome. However, it sits slightly uncomfortably with other clauses we have debated that appear to draw local authorities and the NHS further apart. In this case, it looks like they may be brought together. As the clause expands delegation and joint working powers, I would be interested to understand from the Minister where the oversight and safeguards for accountability for spending the joint budgets would sit. Would it be with the NHS, local authorities or somewhere else? We hope that everything goes well, but if services fail or financial problems emerge, the public deserve to know who precisely is accountable for those budgets. As I have said in debates on numerous other clauses, I continue to be concerned by the broad powers that the Bill gives to the Secretary of State. I have the same concerns about this clause. On Government new clause 20, bringing health services and wider local government functions together is really important, particularly where combined authorities have responsibilities that affect the wider determinants of health. However, once again, I am concerned about the fact that the new clause further complicates an already crowded accountability landscape. As more functions are delivered through pooled budgets and joint arrangements, it becomes harder to identify who is responsible for outcomes, spending decisions and—hopefully not, but potentially—service failures. I welcome the flexibility, which I think has value, but it must be balanced with transparency and democratic accountability. I am not convinced that the new clause gets that right. On new clause 26, as I have said before concerning amendments and new clauses that have come from the Health and Social Care Committee, it is often difficult to get entire agreement on these things because of the cross-party nature of the Committee. Therefore, new clauses and amendments that come out of the Committee are in some ways aspirational, rather than ones that hit the nail on the head. The new clause suggests that the Secretary of State carry out a review of how effective section 75 arrangements are—the hon. Member for Winchester outlined evidence that in some cases, the use of section 75 arrangements has not always been effective—consult NHS bodies, local authorities and anyone else considered appropriate; consider whether existing powers should be used to improve those arrangements; publish a report and lay it before Parliament; explain whether the Government intend to use their powers to change regulations or guidance and why; and complete all that within 12 months of the Bill passing, which I think is a reasonable timeframe. Section 75 arrangements already play an important role in bringing together health and social care. It is reasonable to ask, as the hon. Member for Winchester did, whether they are delivering the benefits in the most effective way possible. I would potentially say that this proposal does not go far enough. The new clause would require a review, a consultation and a report, but would not require any action to follow that. The Secretary of State need only “consider” whether existing powers should be exercised and explain the reasons for any decision. If the review identified significant weaknesses, there is no obligation in the new clause, as far as I understand it, to implement those changes. I agree that the new clause is well-meaning. It has some good recommendations, and I hope the Minister takes on board its sentiment, but it probably does not have the teeth and the power to make it an effective part of the Bill.

• 30 Jun 2026 · Health Bill (Ninth sitting) · Hansard source

  More

  I wish to carry on the point that my right hon. Friend the Member for Melton and Syston has just raised. He rightly says that there is a transparency element to this, so that the public and any other interested party can look at the individual accounts of an ICB or a trust. Going further than that on the technical elements, my understanding is that NHS England’s own guidance notes suggest that consolidation does not just bring accounting under one set of accounts, one umbrella or one document. Within that accounting, however, adjustments and eliminations of transactions between NHS bodies can happen. Therefore, the aggregated figures do not necessarily reflect the financial reality of individual organisations. I understand why that might be entirely appropriate from an accounting point of view, but it can make it harder for external observers to understand exactly where the pressures are coming from, where they are concentrated and, in a world where we want accountability, who should be held responsible for addressing them. That is all I need to say on that point.

• 25 Jun 2026 · Health Bill (Seventh sitting) · Hansard source

  More

  The clause will replace the constitutional requirements contained in paragraph 8(2) to (4) of schedule 1B to the 2006 Act so that “ordinary members” must now include at least one member nominated by the mayor of each mayoral strategic authority whose area coincides with or includes the whole or any part of the ICB’s area. The ICB’s constitution must set out a process for making such a nomination, and a mayor nominating an ordinary member must have regard to any guidance published by the Secretary of State, following the abolition of NHS England, as to the selection of candidates. The definition of a local authority in paragraph 8(7) of schedule 1B to the 2006 Act will be replaced with the definition of a mayoral strategic authority. Sub-paragraph (1), outlining the process to determine the appointment of an ordinary member, and sub-paragraph (6), specifying that one ordinary member must have knowledge and experience in mental health services, are both retained. The clause therefore represents a clear shift in the structure of integrated care boards and, in my view, an unwelcome one, by removing the requirement for representation of GPs, local authorities and NHS trusts, while introducing a requirement for representation from mayoral authorities. Those are not minor features of the system. The inclusion of local authorities in particular was designed to ensure that decision making reflected local needs and supported genuine integration between health and social care. For as long as I can remember, Governments of all colours have talked about bringing health and social care together. Some have been more successful at that than others, but there should be agreement across the House that much more needs to be done. With this clause, the Government seem to be taking at least one step back—I would say numerous steps—from trying to bring health and social care together. Like my hon. Friend the Member for Sleaford and North Hykeham, I watched the Health and Social Care Committee’s discussions with the Minister for Care yesterday, and I too cannot fathom why the Government are doing it. I hope that it is an oversight and that, once the Minister goes away and reflects on it, she will look to table some amendments further down the line—I am sure that she will vote against ours today—so that we can bring these matters back. I am especially concerned about the removal of local authority representation. We are effectively asking local authorities to continue to deliver vital services while removing their voice in the room where strategic decisions about health and social care are made. That raises a fundamental question about how the integration is intended to work in practice. There is also a broader concern about the direction of travel. We are moving away from place-based representation towards a model that places greater emphasis on these mayoral structures, yet the legislation is not prescriptive about who the mayors appoint, and colleagues within and without this Committee have already raised concerns that there is a gap in the understanding at the centre about how local authorities operate in practice. That brings me to the point raised by my hon. Friend the Member for Sleaford and North Hykeham and the hon. Member for Winchester. I apologise; the Minister said that she did not want a geographic tour of our constituencies, but I am afraid that she will get one now. Part of my constituency sits in Hampshire in the Hampshire and Isle of Wight ICB, and as the hon. Member for Winchester said, we may or may not have mayoral elections in a year’s time. Hampshire county council has launched a judicial review against the proposed local government reorganisation; if that is successful, or even if it delays the process, this Bill will come into effect without our having a mayor, and there will be no representation for anybody on this board. We need clarity from the Minister on who will represent the people on the board if there is no mayoral authority. I would say that local authorities—Hampshire county council in this case—should remain on that board, at least until there is a mayoral authority.

• 25 Jun 2026 · Health Bill (Seventh sitting) · Hansard source

  More

  My right hon. Friend is making an absolutely correct point, which I made when we were talking about the Secretary of State’s ability to remove, by sacking or otherwise, the chief executives of ICBs. There is a tension between us as Members of Parliament trying to lobby the Secretary of State for changes in our constituencies when he currently has no power to actually make those changes. The clause will potentially give him the power to make those changes, but being able to sack a chief executive is probably a step too far. How does my right hon. Friend see the powers in the clause, which are probably correct, balancing with the local decision-making process and clinical expertise? There will clearly be a tension between the two.

• 25 Jun 2026 · Health Bill (Seventh sitting) · Hansard source

  More

  It is a pleasure to serve under your chairmanship, Dr Huq. I will speak briefly about clause 15 and amendment 28, tabled in the name of the hon. Member for Oxford West and Abingdon, the Chair of the Health and Social Care Committee, of which I am a member. The amendment is clearly positively intended. We all want the co-production of services, and we have discussed it quite a lot on the Health and Social Care Committee. A number of amendments were tabled in the name of the hon. Member for Oxford West and Abingdon but were agreed on by the Select Committee. I think it is fair to say that there are a number of areas that the Committee could not agree on and that are obviously not in front of it, given its political make-up, but we all agreed on the ones she has tabled. That being said, cross-party agreement often necessitates fairly non-partisan and perhaps non-specific wording, so while I agree with the intention behind the amendment, and while it is clearly important to have co-production when designing services, I am not entirely comfortable with the way the amendment has been drafted. This goes back to comments I made on the Liberal Democrat new clause 2 about how the requirement would operate in practice or how such an approach would be applied consistently across different commissioning functions. Although I am very keen on the principle, I am concerned about the intention.

• 25 Jun 2026 · Health Bill (Seventh sitting) · Hansard source

  More

  My hon. Friend makes two important points. First, of course there has to be a validation process. There has been for a long time, and I do not think that anyone is objecting to that. However, it is a question of how it is being articulated and the people it is focused on. It is being focused on vulnerable people. I have anecdotal evidence from conversations with a significant number of people since I posted that social media video that they feel pressured into coming off the lists. It does not help that trusts have financial incentives to take people off lists. Earlier this month, the Health Service Journal said that three trusts are earning more than £1 million in having people taken off lists. There is no problem with giving trusts a financial reward to do due diligence and validate the lists, but there is potentially a perverse incentive for trusts to try to knock people off them.

• 25 Jun 2026 · Health Bill (Seventh sitting) · Hansard source

  More

  My hon. Friend makes an interesting point that I had not considered before, but she is absolutely right. The upper-tier authorities and strategic mayors might be from different parties, and, where the mayor does not have an actual responsibility for health, there essentially could be democratic deficit there that I had not thought about. My hon. Friend makes an interesting point. That democratic deficit will potentially be exacerbated in the other half of my constituency, which is in Surrey. As I have already alluded to, the Surrey ICB has taken on Frimley but is also now merging with Sussex. As far as I can tell, the Government have absolutely no plans to introduce a mayoral authority in Surrey; however, my quick googling suggests that there will be a mayoral authority in Sussex in 2028, so the mayor of Sussex could be sitting on a board where there is no representation from the Surrey side. That is a complete democratic deficit. There would be the Surrey and Sussex ICB, with representatives for the people of Sussex but not for the people of Surrey. That must be an unfairness. I hope the Minister, if she cannot answer now, will at least go away and think about how that democratic deficit will be avoided. I suggest that she dumps the whole idea and goes back to having the people who actually run health and social care in our country on the board. That is why I am very supportive of amendments 45 and 46, tabled by my hon. Friend the Member for Sleaford and North Hykeham. Reducing the representation to a single mayoral representative is a problem. Reinstating and consolidating the full range of required members and thereby giving the breadth of representation within ICBs that we have all talked about, is essential. It would strengthen the legislative framework, ensuring decision making remains multidisciplinary and balanced and that it incorporates both the clinical expertise, which we are going to lose, and the local authority political input, rather than having a one-sized, over-politicised mayor in charge. By maintaining that membership, the amendments would help safeguard overdominance by a single actor, support a much more informed and locally responsive decision-making process and, crucially, reinforce the collaborative foundation between health and social care that I thought was a given among all parties in this House. I urge the Minister to reconsider what she is proposing in this clause. She should, at least, give us some clarity on what will happen in the interim period or, at best, go back to the drawing board and ensure proper representation of the people who are actually delivering health and social care in our constituencies.

• 25 Jun 2026 · Health Bill (Seventh sitting) · Hansard source

  More

  My hon. Friend tempts me to be political; I will rise to that briefly. Yes, I have seen them and she is right. There is a clear concern that when the Government make all these proclamations about how brilliant the NHS has suddenly become, the reality on the ground does not meet that for many patients. However—I am being gentle now—that is probably not exclusively a problem with this Government. My right hon. Friend the Member for Melton and Syston might kill me, but I am sure other Governments have done something similar. I will go back to amendment 52 because I think it is really important. Let me be clear: it would not prevent people being removed where appropriate; it would simply require the Government to be honest about why. It requires the Secretary of State to publish the number of patients removed from waiting lists each month and, crucially, the reasons why. If everything is being done properly there should be nothing to fear from such transparency, but if there are problems, sunlight is the best disinfectant and the amendment is exactly what we need. We owe it to our constituents and to every patient in the country to ensure that waiting lists are not improved just on paper, or in a press release, or in a social media tweet, or at the expense of the care of real people but actually improved. If we are to strengthen patient choice, particularly in relation to community services that substitute for or prevent hospital admission and treatment, there are some good measures in clause 16. However, as my hon. Friend the Member for Sleaford and North Hykeham said, there are concerns, so I hope the Minister will be able to pick those up in her comments when she winds up.

• 25 Jun 2026 · Health Bill (Seventh sitting) · Hansard source

  More

  My hon. Friend is absolutely right. The danger in this process—especially the multiple instances of chasing within a period of weeks, which sometimes happens—is that pressure is put on patients. Again, I know anecdotally from patients who have been speaking to me that those who are most compliant—if I can put it like that—and do not want to make a fuss are generally older and vulnerable people, who feel that they are perhaps causing an inconvenience to the system. They see people with, in their view, more serious conditions or a greater need. We need to be very careful about creating perverse incentives, financial or otherwise, to try to take some of those people off the list. As I say, the significant jump that we have seen deserves more scrutiny and inquiry, and that is why I am very supportive of my hon. Friend’s amendment. We need to understand whether patients are being removed because they no longer require treatment, as the hon. Member for Bury St Edmunds and Stowmarket said—which is, of course, entirely appropriate—or just to improve targets, present an improved picture of waiting lists, and unlock the financial benefits tied to performance metrics. There is a troubling echo here. We saw similar practices in the 2000s when patients were removed or reclassified in ways that reduced waiting list numbers without genuinely improving access to care; it damaged confidence in the system then and it risks doing so now. What concerns me most is that we may be repeating that pattern. If the Government find they cannot meet their waiting list targets, there is a real danger that the pressure to do so will translate into decisions that, intentionally or not, compromise patient safety and fairness.

• 25 Jun 2026 · Health Bill (Seventh sitting) · Hansard source

  More

  Amendment 35 has not been moved, but it is very similar to new clause 35, which may be moved and concerns equipment. I will address both together. I think all in this Committee would agree that ensuring timely access to community equipment and wheelchair services is vital for patient independence, dignity and recovery. I have a number of constituents who believe that they are not getting access to that equipment in the time they would expect. We also need to ensure that we give proper consideration to the efficiency and management of resources. In particular, we should look more closely at what happens after that equipment has been distributed. Too often, items such as crutches, wheelchairs or Zimmer frames are not reviewed after issue or returned when they are no longer needed. We are already seeing a massive financial consequence of that. It was reported last year that the Royal Berkshire NHS foundation trust is losing around £70,000 a year due to patients retaining unused mobility equipment. That might seem like a drop in the ocean for the NHS, but £70,000 could fund another nurse, if we include the on-costs. These things do have consequences. Despite distributing thousands of items, only 38% of crutches and just 15% of Zimmer frames were returned in 2024. That represents a significant loss of reusable equipment and considerable pressure on NHS resources. It also gets into the mindset of how patients use and value those pieces of equipment and how NHS users think about resources. While I think that we all agree in this Committee that the NHS should be free at the point of use, one of the downsides of that is that patients rarely think about what the cost of their care contributes. I personally think that if people understood how much crutches or medicines cost, they would use them much more usefully. Plenty of times I have spoken to pharmacists in my constituency who tell me that once a patient has unfortunately died, their family then comes to the pharmacy with a sackload of drugs that have never been used. I think that if people understood the cost of those things, they would use them more effectively and with more caution. This is not an isolated issue but indicative of a wider problem across the system. If we were to introduce firm timelines for provision, we would need to ensure that there is a robust process for recovery, reuse and proper management of that equipment. Therefore, while I am not supportive of amendment 35 or new clause 35, I ask the Government to consider how those proposals could be strengthened by embedding clear expectations about the return and reuse of that equipment so that public funds are used as effectively as possible. I will now turn to the two amendments in the name of my hon. Friend the Member for Sleaford and North Hykeham. Amendment 51 is important because, while I understand the Government’s intention in clause 16, as my hon. Friend has mentioned, her amendment will prevent any artificial delays in treatment by ensuring patients are seen as soon as clinically appropriate, rather than being required to wait a minimum period. It simply protects the principle that care should be based on medical need—which I think we would all agree on—rather than some administrative target. It helps avoid situations where waiting times are managed on paper rather than reduced in reality. That ultimately safeguards patient outcomes and timely access to care. Moving on to amendment 52, I add my strong support to this amendment, because it goes to the heart of trust, transparency and patient safety in the health system. I have been speaking to constituents and individuals from across the country who have contacted me after a video I posted on my social media that contributed to the exposure of the removal of 351,000 patients from waiting lists in March of this year. The stories I have heard are deeply troubling. Those include patients who have waited years for potentially life-changing treatment only to receive notification late—or in some cases not at all—that they have been removed from the list. For many it came as a shock, while for some it came after months or years of uncertainty. This is not some trivial administrative matter. I would sum up the Minister, when responding to questions on this point, as: “Nothing to see here, this is what always happens.” There has been such a significant jump over a period of two months that there has to be something going on here. The experiences of patients who have spoken to me about this suggest that that is happening. For those patients it is the difference between treatment and deterioration, between hope and abandonment. It is also undoubtedly affecting more vulnerable and less technologically savvy pockets of society, such as the elderly.

• 25 Jun 2026 · Health Bill (Seventh sitting) · Hansard source

  More

  There have been a number of reports of situations where people have not received care and have died because of that, so I do not see the hon. Member’s point. I think that, with amendment 52, my hon. Friend the Member for Sleaford and North Hykeham is trying to ensure that when the statistics are published, we can scrutinise the reasons behind them. The hon. Member for Ashford may be entirely right; let us imagine that is the case, and there is no gamifying or pressure going on. Why not allow the public to see that? Why not put to bed the HSJ stories that say there is something fishy going on? He should welcome that level of transparency and scrutiny to back up his argument if he is correct.

• 25 Jun 2026 · Health Bill (Seventh sitting) · Hansard source

  More

  The hon. Gentleman is entirely correct, and I think I said some moments ago that I am not against a validation of the list—I think I even said that I am not against some sort of financial incentive to clear the list. My concern is the extraordinary jump in the baseline in the last month or so: 351,000 people have been removed from the list for no apparent reason. While I have been having anecdotal discussions with patients, my hon. Friend the Member for Sleaford and North Hykeham has been doing something a little more robust. It would be interesting to see the outcome of her endeavours and researches and to find out exactly what is happening in those areas. Anyone with a modicum of inquiry and common sense would say that the significant jump that we have seen in a single month deserves at least a level of interrogation, which the hon. Member for Bury St Edmunds and Stowmarket is not allowing in his comments.